Most Relevant Information
Provider Data
| NPI Number: | 1003321522 |
| Provider Name: | DANIEL DEWITT CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SLP009349 |
Most Important Dates
| Enumeration Date: | 12/06/2017 |
| Last Updated: | 12/06/2017 |
Provider Practice Location
311 COOPER RD
LOGANVILLE
GA
300524976
Practice Location Phone/Fax
| Phone: | 6782055437 |
| Fax: |
Provider Mailing Location
2340 MATLIN WAY
BUFORD
GA
305197191
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |